ACTIVE DECOMPRESSION IMPROVES THE HEMODYNAMIC STATE DURING CARDIOPULMONARY-RESUSCITATION

Objective-To examine whether use of the active compression-decompressi on device improves the haemodynamics of cardiopulmonary resuscitation compared with those of conventional cardiopulmonary resuscitation. Des ign-Prospective crossover study. Setting-The accident and emergency de partment of a university teaching hospital. Patients-36 adult patients with nontraumatic, normothermic, out of hospital cardiac arrest. Inte rventions-Cardiopulmonary resuscitation was performed during resuscita tion in alternating 3 min cycles of conventional and active compressio n-decompression cardiopulmonary resuscitation. Main outcome measures-T he end tidal carbon dioxide (ETco(2)), femoral arterial pressure, and acid-base analysis of central venous blood measured during the last 30 s of each 3 minute cardiopulmonary resuscitation cycle. Results-ETco( 2) was monitored in 36 patients during conventional and active compres sion-decompression cardiopulmonary resuscitation. Active compression-d ecompression cardiopulmonary resuscitation caused a significant increa se in ETco, (P < 0.0002), indicating improved cardiac output. Arterial pressure measurement was carried out in 10 patients. Systolic pressur e was significantly greater with active compression-decompression than conventional cardiopulmonary resuscitation (P < 0.007). Central venou s blood was taken for acid-base analysis in 11 patients. There was a s ignificant increase in the central venous hydrogen ion concentration, (P = 0.025) with rises in the partial Edinburgh pressures of carbon di oxide and oxygen, suggesting improved venous return. Conclusions-This study confirms that active compression-decompression cardiopulmonary r esuscitation is associated with better haemodynamic status than conven tional resuscitation.